title: Psychological considerations in revision rhinoplasty.
abstract: Revision rhinoplasty is a unique challenge. In addition to the technical considerations that are inherently more difficult than those of primary cases, the surgeon must also be mindful of the psychological considerations that revision rhinoplasty presents. These patients are by definition unhappy with their prior rhinoplasty experience, and this perception of a suboptimal result is both legitimate and real, even if the surgeon is not in agreement. Tantamount to any intraoperative technique, the preoperative ability of the surgeon to sift through the myriad psychological and psychosocial issues is critical to achieving satisfactory outcomes for both patient and surgeon. Reasons for dissatisfaction with a primary surgery, reasons for seeking revision surgery, and the psychological profiles of revision rhinoplasty patients can differ from those related to other facial cosmetic procedures. This article attempts to provide the reader with a better understanding of the complex interplay of these issues and with this understanding help the reader to distinguish one who is a favorable surgical candidate from one who is best left unrevised.
authors.affiliation: Division of Facial Plastic and Reconstructive Surgery, Department of Otorhinolaryngology-Head and Neck Surgery, University of Maryland Medical Center, Baltimore, Maryland 21201, USA. bryanambro@yahoo.com
authors.forename: Bryan T
authors.initials: BT
authors.lastname: Ambro
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Wright
mesh_terms: D001007:Anxiety / Q000523:psychology; D001294:Attitude to Health; D001883:Borderline Personality Disorder / Q000523:psychology; D003193:Compulsive Personality Disorder / Q000523:psychology; D005260:Female; D006677:Histrionic Personality Disorder / Q000523:psychology; D006801:Humans; D008297:Male; D019964:Mood Disorders / Q000523:psychology; D010324:Passive-Aggressive Personality Disorder / Q000523:psychology; D010342:Patient Acceptance of Health Care; D017060:Patient Satisfaction; D010554:Personality Disorders / Q000523:psychology; D010817:Physician-Patient Relations; D012086:Reoperation; D012225:Rhinoplasty / Q000379:methods / Q000523:psychology*; D012649:Self Concept; D012737:Sex Factors; D012917:Social Adjustment; D016896:Treatment Outcome